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At least 631 records · Page 35Linked to original sources
PubMed1985

Compressed heart and mitral valve prolapse in a case of Duchenne's progressive muscular dystrophy with thorax deformity.

We report on a 15 year old patient with Duchenne's progressive muscular dystrophy who demonstrated a narrowing of the left ventricular inflow and outflow tracts due to compression by a highly deformed thoracic spine. A systolic murmur (4/6) with thrill and a diastolic murmur (2/6) were heard, with these murmurs being louder in the expiratory phase as compared with the inspiratory phase. The second heart sound showed a paradoxical splitting. Echocardiograms revealed a compressed and narrowed left ventricle and a prolapsed mitral valve. The intensities of the heart murmurs changed synchronously with the chamber's narrowing due to respiration. A narrowed left ventricle occurring as a result of the compression by the deformed thoracic spine is thought to be the cause of these cardiac findings.

Adolescent↗
PubMed2006

Time-resolved contrast-enhanced MR angiography of the thorax in adults with congenital heart disease.

OBJECTIVE: The aim of this study was to evaluate the diagnostic value of time-resolved contrast-enhanced MR angiography in adults with congenital heart disease. SUBJECTS AND METHODS: Twenty patients with congenital heart disease (mean age, 38 +/- 14 years; range, 16-73 years) underwent contrast-enhanced turbo fast low-angle shot MR angiography. Thirty consecutive coronal 3D slabs with a frame rate of 1-second duration were acquired. The mask defined as the first data set was subtracted from subsequent images. Image quality was evaluated using a 5-point scale (from 1, not assessable, to 5, excellent image quality). Twelve diagnostic parameters yielded 1 point each in case of correct diagnosis (binary analysis into normal or abnormal) and were summarized into three categories: anatomy of the main thoracic vessels (maximum, 5 points), sequential cardiac anatomy (maximum, 5 points), and shunt detection (maximum, 2 points). The results were compared with a combined clinical reference comprising medical or surgical reports and other imaging studies. Diagnostic accuracies were calculated for each of the parameters as well as for the three categories. RESULTS: The mean image quality was 3.7 +/- 1.0. Using a binary approach, 220 (92%) of the 240 single diagnostic parameters could be analyzed. The percentage of maximum diagnostic points, the sensitivity, the specificity, and the positive and the negative predictive values were all 100% for the anatomy of the main thoracic vessels; 97%, 87%, 100%, 100%, and 96% for sequential cardiac anatomy; and 93%, 93%, 92%, 88%, and 96% for shunt detection. CONCLUSION: Time-resolved contrast-enhanced MR angiography provides, in one breath-hold, anatomic and qualitative functional information in adult patients with congenital heart disease. The high diagnostic accuracy allows the investigator to tailor subsequent specific MR sequences within the same session.

Adolescent↗
PubMed2005

Radiofrequency ablation of thoracic lesions: part 1, experiments in the normal porcine thorax.

OBJECTIVE: Radiofrequency ablation has been used extensively in the liver for the localized thermal coagulation of tumors. It has been applied more recently percutaneously in the lung under CT imaging guidance. In advance of our own clinical application, we performed experimental percutaneous radiofrequency ablation in normal lung tissues in a large animal model using a U.S. Food and Drug Administration-approved device to assess its use. MATERIALS AND METHODS: Radiofrequency ablation of 22 thoracic sites was performed in vivo in three pigs with an array-style electrode. Tissue impedance and ablation duration were measured for each site. The intact lungs were excised for gross inspection and for imaging with CT and MRI. Representative lesions were evaluated histologically. RESULTS: The mean intraprocedural tissue impedance was 93 Ohms (range, 52-184 Ohms). Six of 22 ablations exhibited a marked increase in impedance after 5 min of treatment. On gross inspection, parenchymal lesions were generally round and targetlike in appearance. CT showed sites of ablation to be composed of a heterogeneous inner zone surrounded by a high-density outer zone. On MRI, the inner zone was typically hyperintense on T1-weighted fast spin-echo imaging, and the outer zone was hyperintense on T2-weighted fast spin-echo imaging. At histology, the inner zone was characterized by coagulation necrosis, and the outer zone by hyperemia and edema. No acute lung-specific complications were seen. There was one extensive skin burn and one cardiac-related death. CONCLUSION: These results support current seminal clinical evidence that percutaneous radiofrequency ablation in the lung is feasible and can be applied safely. Radiofrequency-induced lesions in the normal porcine lung can be visualized with both CT and MRI; image appearance is concordant with histologic tissue changes.

Animals↗